Final outcome of 223Ra-therapy and the role of 18F-fluoride-PET in response evaluation in metastatic castration resistant prostate cancer -a single institution experience

223Ra was the first therapeutic alpha-emitting radionuclide registered for clinical practice. This radionuclide is targeting actively bone forming cells, and it is approved for treating metastatic skeletal disease in prostate cancer. 18F-PET is used to detect skeletal metastatic disease based on osteoblastic activity. The aim of this study was to analyze, if 18F-PET can be used assessing the results of 223Ra therapy, and to report final median overall survival in a total of 773 therapy cycles.

A 161 men with castration resistant prostate cancer were included in a single institution study (Protocol#: PA14-0848) and they received a total of 773 223Ra therapy cycles.

The median overall survival (95% CI) was 12.4 (9.1, 16.1) months in patient population. Interim Na18F-PET imaging was applied in 14 patients at baseline, after 3 cycles and after 6 cycles. TLF10 (skeletal disease burden at SUV-values >10 on Na18F -PET) were calculated in all these PET studies, and there was no significant association between change in TLF10 after 3 cycles and TLF10 after 6 cycles (p=0.20).

From these results we conclude that interim imaging does not help in assessing the final outcome of 223Ra therapy. The survival benefit of 223Ra therapy alone is more than a year in a high risk group of advanced prostate cancer.

Current radiopharmaceuticals. 2018 Jun 29 [Epub ahead of print]

Kalevi Kairemo, Denai R Milton, Elba Etchebehere, Eric M Rohren, Homer A Macapinlac

Department of Nuclear Medicine, The University of Texas MD Anderson Cancer Center, Houston. United States., Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston. United States.


Newsletter subscription

Free Daily and Weekly newsletters offered by content of interest

The fields of GU Oncology and Urology are rapidly advancing. Sign up today for articles, videos, conference highlights and abstracts from peer-review publications by disease and condition delivered to your inbox and read on the go.